Provider Demographics
NPI:1316597339
Name:HARNED, ANNE GERLICHER (PA-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:GERLICHER
Last Name:HARNED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:FRANCES
Other - Last Name:GERLICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-0488
Mailing Address - Country:US
Mailing Address - Phone:805-286-3826
Mailing Address - Fax:
Practice Address - Street 1:1130 NW 22ND AVE STE 110
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2934
Practice Address - Country:US
Practice Address - Phone:503-413-8654
Practice Address - Fax:503-413-8655
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORPA201457363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program